Anatomy of an ear infection slideshow

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Ear infections: All too common

Ear infections are extremely common. Research indicates that when young children get colds, they end up with an ear infection more than 50% of the time. Keep reading to find out why.

Diagnosing an ear infection

Doctors usually diagnose an ear infection by examining the ear and the eardrum with a device called an otoscope. A healthy eardrum (shown here)appears translucent and pinkish-grey. An infected eardrum looks red and swollen.

Anatomy of an inner ear infection

The Eustachian tube is a canal that connects the middle ear to the throat. It is lined with mucus, just like the nose and throat; it helps clear fluid out of the middle ear and maintain pressure levels in the ear. Colds, flu and allergies can irritate the Eustachian tube and cause the lining of this passageway to become swollen.

Fluid in the ear

If the Eustachian tube becomes blocked or narrowed, fluid can build up in the middle ear. This creates a haven for bacteria and viruses, which can cause infection. Doctors can detect fluid in the middle ear with a pneumatic otoscope. This device blows a small amount of air at the eardrum, making the eardrum vibrate. If fluid is present, the eardrum will not move as much as it should.

Perforated eardrum

When too much fluid or pressure builds up in the middle ear, it can put pressure on the eardrum that may then perforate (shown here). Signs of a perforated eardrum include yellow, brown or white fluid draining from the ear. Pain may disappear suddenly because the pressure of the fluid on the eardrum is gone. Although a perforated eardrum sounds frightening, it usually heals itself in a couple of weeks. Unless it happens repeatedly, perforations should have no permanent effect on hearing.

Ear infection symptoms

The hallmark of an acute ear infection is piercing pain in the ear. The pain may be worse when lying down, making it difficult to sleep. Other symptoms include:

Trouble hearing

Fever

Fluid drainage from ears

Dizziness

Congestion

Ear infection symptoms: Babies

It can be difficult to identify an ear infection in babies or children who are too young to tell you where it hurts. Signs to watch for are tugging or pulling on an ear, irritability, trouble sleeping and loss of appetite. Babies may push bottles away or resist breastfeeding because pressure in the middle ear makes it painful to swallow.

Home care for ear infections

Although the immune system puts up its fight, you can take steps to ease the pain of an ear infection. Applying a warm flannel to the ear can be soothing. Over-the-counter painkillers such as age-appropriate ibuprofen or paracetamol, are also an option. Always read the label. Never give aspirin to children under 16.

Antibiotics for ear infections

Antibiotics can help a bacterial ear infection, but in most cases the infection is caused by a virus and the child’s immune system can fight off the infection without help. Currently antibiotics for ear infections are only recommended in certain circumstances. These include a child showing no signs of improvement after 4 days.

Complications of ear infections

Chronic or recurrent middle ear infections can have long-term complications. These include scarring of the eardrum with hearing loss, and speech and language developmental problems. A hearing test may be needed if your child suffers from chronic or frequent ear infections.

Ear tubes

If your child has recurrent ear infections or fluid that just won't go away, hearing loss and a delay in speech may be a real concern. One solution is for small tubes (grommets) to be inserted through the eardrum. Ear tubes let fluid drain out of the middle ear and prevent fluid from building back up. This can decrease pressure and pain, while restoring hearing. The tubes are usually left in for eight to 18 months and usually they fall out on their own.

Surgery to remove the adenoids

Adenoids are glands located high in the back of the throat. They can become enlarged and can affect the Eustachian tubes that connect the middle ears and the back of the throat. An adenoidectomy (removal of the adenoids) may be carried out when chronic or recurring ear infections continue despite appropriate treatment - or when enlarged glands cause a blockage of the Eustachian tubes.

Preventing ear infections

The biggest cause of ear infections is the common cold, so try to keep cold viruses at bay. The most effective way to do this is frequent and meticulous hand washing. Other lines of defence against ear infections include avoiding secondhand smoke, vaccinating your children and breastfeeding your baby for at least six months.

Allergies and ear infections

Like colds, allergies can irritate the Eustachian tubes and contribute to middle ear infections. Getting allergies under control can help reduce the risk of ear infections.

Swimmer's ear

Otitis externa, sometimes called “swimmer's ear”, is an infection of the ear canal. It can occur when water or debris gets trapped in the ear canal. Bacteria breed in the water and cause pain, swelling and itching of the ear canal. Although it's often associated with swimming, anyone can get swimmer's ear. Breaks in the skin of the ear canal, such as from scratching or using cotton buds, can also increase risk of infection. The condition is usually treated with medicated ear drops and keeping the ear dry.

Academy of American Family Physicians
American Academy of Otolaryngology
Chonmaitree, T. Clinical Infectious Diseases, March 15, 2008.
Chavanet, P. Clinical Infectious Diseases, March 15, 2008.
Merck
US National Institute on Deafness and Other Communication Disorders
Sander, R. American Family Physician, March 1, 2001.
Spiro, D. JAMA, The Journal of the American Medical Association, Sept. 13, 2006.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general information purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the BootsWebMD Site. If you have a medical problem please contact your GP. In England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.

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